ORAL HEALTH EVIDENCE-BASED PRACTICE PROGRAM
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Title Ascorbic Acid Supplementation Ineffective as Therapy for Periodontal Disease
Clinical Question Does ascorbic acid supplementation provide therapeutic effects in treating periodontal disease?
Clinical Bottom Line Ascorbic acid supplementation does not prove promising as an antioxidant therapy in treating periodontal disease, but it does play a role in inhibiting alveolar bone resorption and could play a role in developing medicines that promote differentiation of periodontal ligament progenitor cells into bone cells.
Best Evidence (you may view more info by clicking on the PubMed ID link)
PubMed ID Author / Year Patient Group Study type
(level of evidence)
#1) 20569170Abou/2010Patients with Chronic PeriodontitisRandomized Controlled Trial
Key resultsWhile other methods of periodontal therapy enhanced antioxidant therapy (TAOC), the supplemental dose of ascorbic acid did not prove to provide any further therapeutic benefit to patients in the trial.
#2) 22702517Akman/2012RatsLaboratory study
Key resultsAlpha lipoic acid and ascorbic acid played a part in inhibiting alveolar bone resorption and destruction of periodontal tissue, thereby providing therapeutic benefit.
#3) 23836152Yan/2013Progenitor CellsLaboratory study
Key resultsAscorbic acid activates the differentiation of periodontal ligament progenitor cells leading to ossteogenesis through the PELP1-ERK axis. For this reason, ascorbic acid may play a role in developing medicines which promote regeneration as treatment for periodontitis.
Evidence Search ascorbic acid and periodontitis
Comments on
The Evidence
Validity: The Abou (2010) study contained a randomized controlled trial with groups that were similar at the start and treated the same with adequate follow-up. The study was not double blind but eliminated the need to evaluate adequacy of compliance and recall bias through the design of the study. The Akman (2012) laboratory study involved rats and started with similar groups that were treated the same through the trial. The experiment was not double blind but it demonstrated adequate follow-up. The Yan (2013) laboratory study exposed periodontal ligament progenitor cells to ascorbic acid. Because of the nature of the study, the groups were similar at the start and demonstrated an adequate completion rate without recall bias. Perspective: Although ascorbic acid has been shown to be an integral component of connective tissue development and used in the prevention of soft issue and bone breakdown, the use of ascorbic acid in the actual treatment of periodontitis has not be evaluated thoroughly. These studies could provide the information needed to determine how a natural and abundant substance such as ascorbic acid could be used to promote regeneration of soft and hard tissues of the oral cavity after destruction from periodontal disease.
Applicability At the current time, the use of ascorbic acid supplementation does not present as a therapy for patients with any form of periodontal disease.
Specialty/Discipline (General Dentistry) (Periodontics)
Keywords ascorbic acid periodontal disease
ID# 3088
Date of submission: 04/15/2016spacer
E-mail JosephM3@livemail.uthscsa.edu
Author Maria Joseph
Co-author(s)
Co-author(s) e-mail
Faculty mentor/Co-author Georgiana Gross, RDH, MPH
Faculty mentor/Co-author e-mail GROSSG@uthscsa.edu
Basic Science Rationale
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